The Impact of Bombing Attacks on Civilians in Iraq

The Experiences of People From Arab Countries in Coping with Trauma Resulting From War and Conflict in the Middle East: A Systematic Review and Meta-synthesis of Qualitative Studies

The Middle East region has been an area of war and political conflict for several decades. There is currently limited research on the experiences of war and conflict among the individuals from Arab countries in the Middle East. The aim of this review was to systematically review and meta-synthesize qualitative literature on the experiences of individuals from Arab countries in the Middle East of going through and coping with war and political conflict. We systematically searched for relevant literature through MEDLINE, PsycINFO, CINAHL, Google Scholar, EThOS, OpenGrey, and The Arab Journal of Psychiatry. Studies selected needed to have a qualitative design reporting on the war and conflict experiences of participants aged 18 years or older from Arab countries in the Middle East. The review protocol was preregistered with PROSPERO (Ref: CRD42022314108). We identified 27 studies to be included in the final review. Four overarching themes were included in the meta-synthesis: War and conflict as life-defining experiences, experiences of hardship, coping with war and conflict, and positives out of a painful experience. Participants in the included studies reported significant distress and losing their sense of self, as well as resilience and positive growth. This review and meta-synthesis revealed the particular culturally informed experiences of individuals from Arab countries in the Middle East in processing their conflict experiences. These experiences highlight the need for culturally sensitive interventions for a population that has been under significant war-related stressors.

Posttraumatic stress disorder and death anxiety among Iraqi civilians exposed to a suicide car bombing: the role of religious coping and attachment

BACKGROUND

Posttraumatic stress disorder (PTSD) as a result of a bombing has been studied in the literature. Limited studies have focused attention on PTSD following a suicide car bombing. However, more research is needed to explore the risk factors for this psychological response.

AIMS

To examine a hypothesised model that death anxiety would be associated with PTSD and psychiatric comorbidity following a suicide car bombing, and that attachment styles and religious coping would influence the impact of this anxiety on distress outcomes.

METHODS

185 Iraqi civilians exposed to the first suicide car bombing completed questionnaires measuring PTSD, psychiatric comorbidity, death anxiety, religious coping, and attachment experiences.

RESULTS

82% met diagnostic criteria for PTSD, the remainder did not. Path analysis showed that death anxiety was significantly correlated with psychiatric comorbidity; it was also correlated with attachment, which was correlated with psychiatric comorbidity. Death anxiety was also significantly correlated with religious coping, which was correlated with both distress outcomes.

CONCLUSIONS

Although Iraqi civilians reported increased death anxiety following a suicide car bombing, those who used religion to cope with the traumatic experience and had functional attachment experiences in the past reported low levels of psychological distress.

The trajectory of bombing-related posttraumatic stress disorder among Iraqi civilians: Shattered world assumptions and altered self-capacities as mediators; attachment and crisis support as moderators

This study examined the impact of bombing on posttraumatic stress disorder (PTSD) and psychiatric co-morbidity over time, whether this relationship was mediated by shattered world assumptions and altered self-capacities, and whether the mediational effects were moderated by attachment style and crisis support among Iraqi civilians. One hundred and fifty-nine Iraqi civilians completed questionnaires measuring the aforementioned psychological constructs. Bombing exposure was associated with PTSD and psychiatric co-morbidity over time; 87% and 77% met the criteria for PTSD at baseline and five months respectively. Shattered world assumptions and altered self-capacities mediated the impact of bombing exposure on PTSD and psychiatric co-morbidity over time. The mediational effect for shattered world assumptions was not moderated by attachment style and crisis support. However, the mediational effect for altered self-capacities was moderated by fearful attachment and a medium level of crisis support. To conclude, following bombing, Iraqi civilians' assumptions about the world and others can change. These changes can have long term effects on psychological distress but are not influenced by childhood attachment experiences or the amount of crisis support received. Bombing can also change civilians' perceptions of internal capacities like emotional regulation, particularly those with fearful attachment who rely on crisis support to some extent.